Opinion: Data-driven health care policy goal of CHI

By Michele Lueck

As the Colorado Health Institute observes its 10th anniversary this year, we are spending a bit of time looking back but much more time thinking about the future of health care in our state.

CHI was founded in 2002 to address a gap in sound health policy data and analysis, particularly independent and impartial information. Today, the need for reliable data and research has never been greater as leaders in the public, private and nonprofit sectors work to transform Colorado’s health care system – an increasingly costly system that isn’t working as well as it should for nearly anybody.

This is a time of extraordinary change in health care. Most people are familiar with the revisions in the Affordable Care Act. But many may not realize the level of innovation that is underway in Colorado regardless of changes in the law, particularly collaborative efforts that would have been unthinkable even a decade ago.

Most of these projects are working toward three common goals – improving how patients experience the health care system, increasing the health of all Coloradans, and reducing the per-capita cost of health care by making it more efficient and effective. Meanwhile, there’s widespread recognition that stronger preventive health for individuals and better overall health for our communities will be important components of successful change.

With that in mind, here are CHI’s top five Colorado health care trends heading into 2013 – and CHI’s second decade:

1.    More public-private partnerships

Dozens of health care collaborations are being tested in Colorado, with private insurance payers, health care organizations and clinicians, among others, joining with public programs such as Medicare and Medicaid to try new ideas. It’s tough work that calls for fundamentally rethinking how health care is delivered, how it’s paid for and how to make it more transparent, especially for patients. The bottom line of these collaborations is a sharing of the risks and the rewards. One unique initiative to keep an eye on: The Colorado Comprehensive Primary Care Initiative is bringing public and private insurers together to expand comprehensive primary care and the medical home model in 73 primary care practices across Colorado.

2.    Integrating all aspects of patient care

Moving from a scattered, fragmented system to one that integrates every part of a patient’s care, including primary care, specialty care, oral health and behavioral health, is a top priority.  The Colorado Department of Health Care Policy and Financing is conducting a pilot program that has the potential to be a transformative model.  The Accountable Care Collaborative divides the state into seven regions and challenges regional coordinators to enroll Medicaid clients in “medical homes” that oversee and integrate their care. Nearly 150,000 Coloradans are in the ACC project, with an anticipated 200,000 set to be signed up soon. Early results looking at whether the program can lower expensive emergency room visits and hospital stays are encouraging. Meanwhile, Colorado tapped leaders across the state to help draft an application for a competitive State Innovation Models grant that would further support these ground-breaking efforts.

3.    A Colorado flavor of payment reform

State lawmakers approved a bill in the 2012 session that sets the stage to experiment with different payment models in the Medicaid pilot program, allowing for a move away from the traditional fee-for-service payment system to variations of a global payment system that would reward caregivers for providing more efficient, integrated care. This was a bipartisan effort that continues the creative and forward-looking work by Colorado’s legislators related to health reform. Stay tuned.

4.    Big questions for small employers

Colorado employers with the largest part-time work forces face important questions in 2013 as they prepare to comply with health insurance requirements. Beginning in 2014, most large employers must provide coverage for employees working 30 hours or more each week or face penalties.  In Colorado, most of these businesses are in the retail and hospitality industry. Looking at significant new expenses, CHI anticipates that many of these businesses will consider curtailing worker hours.

5.    A steep learning curve: purchasing insurance

We’re heading into a brave new health insurance world. There will be many options for purchasing coverage – the Small-Employer (SHOP) Exchange, the Individual Exchange, private exchanges, the broker market. There will be myriad choices as well – basic health plans, gold plans, silver plans, bronze plans. The good news is that there should be more transparency, making comparisons easier. But it will be a new frontier, and CHI expects that there will be confusion and anxiety as change kicks in.

CHI also recognizes that policies and decisions made in Colorado affect real people, about 5 million of our fellow Coloradans. With that in mind, CHI is marking its anniversary with the publication of a photo book titled “Colorado: A Picture of Health.”

The book shows Coloradans on the front lines of health care – providers, patients, educators, students, volunteers and community health advocates. It covers the state from Montrose to Las Animas, from inner city Denver to the San Luis Valley. And it depicts all ages, from a minutes-old baby to seniors working to stay healthy and vibrant.

This book is a gift back to the community for its support of CHI over the past 10 years.

Today, CHI is a trusted source of health care data, information, evidence and analysis for a wide range of Coloradans, including policymakers on the local, county, regional and state levels, policy and advocacy groups, businesses and organizations providing health care, public and private health care payers, educators, journalists and interested citizens.

Our mission is to help make Colorado – and all Coloradans – healthier.

Contact Brian Clark at clarkb@coloradohealthinsitute.org for a copy of the book. Or view it online at http://www.coloradohealthinstitute.org/blog/detail/chi-releases-photo-book-to-mark-10-years.

Michele Lueck is president and CEO of the Colorado Health Institute. She joined the organization in November 2010, bringing nearly 20 years of health and health care experience. Her work ranges from consulting with leading academic organizations to serving rural health care providers.  Her expertise in strategic communications informs the current work and direction of CHI.